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STUDY OF YEAST SPECIES ISOLATED FROM CLINICAL SPECIMENS

Opportunistic yeast infections are very common in patients with malignancy or some form of immuno-suppression. Conventional methods of yeast identification are time consuming and labour intensive whereas commercial methods are expensive and beyond reach of most laboratories. Disk diffusion method offers a relatively simple, inexpensive and rapid method of identifying yeasts. 63 specimens of yeasts were isolated and identified from 68 patients by conventional methods. With disk diffusion method 54 of 63 species (85.7%) gave the same identification.

Recent advances in tuberculosis diagnostic techniques.

Tuberculosis is re-emerging as an important cause of morbidity and mortality in man. This article outlines current strategies available for the diagnosis of tuberculosis, and its applicability. Fluorescent staming, modified culture methods, antigen detection, ELISA based assays against various antigen preparation and recent advances in molecular techniques have been outlined. Present strategies being developed at Armed Forces Medical College for the early diagnosis, speciation, antibiotic sensitivity testing and epidemiologic testing have also been alluded to.

ANTIBIOTIC RESISTANCE PATTERN OF ISOLATES FROM WOUND AND SOFT TISSUE INFECTIONS

Two-hundred and eighty bacterial isolates from wound and soft tissue infections were studied for species identification and antibiotic resistance pattern. Amongst them 122 isolates were from community acquired infection and 158 were from nosocomial infections. The common community acquired pathogens were Staphylococcus aureus (67.8%) and Streptococcus pyogenes (10.7%), whereas Staphylococcus aureus (60.1%) and E. Coli (8.9%) were common in nosocomial infection. Only two anaerobes (Cl perfringens) were isolated. Penicillin resistance was found to be 87% and 92% for Staphylococccus aureus in community acquired and noscomial infections respectively. 85% of Proteus isolates were resistant to ampicillin. There was relatively lower level of resistance by all isolates to cefotaxime. Gentamicin showed higher rate of resistance than netilmicin and amikacin. Resistance of E. coli isolates to fluoroquinolones being 79% for norfloxacin, 81% for ciprofloxacin and 60% for ofloxacin. The study showed a higher resistance of methicillin resistant Staphylococcus aureus (MRSA) to other antibiotics. Amikacin and ofloxacin were the best recommended drugs for empirical therapy for all organisms, the susceptibility rate being 80.7% and 80.4%.

UREAPLASMAS UREALYTICUM AND HUMAN INFERTILITY: EFFECT ON SPERMATOZOA MORPHOLOGY

Seminal fluids of 197 males with complaints of involuntary infertility were examined for spermatozoal counts, morphological changes in the spermatozoa and cultured for ureaplasmas and mycoplasmas. In 12, no spermatozoa were present, 29 had a count of less than one million and 156 had more than one million spermatozoa per mL of the seminal fluid. Various morphological changes were detected in the spermatozoa in some cases. U urealyticum and M hominis were grown in 43.15% and 16.75% in comparison to control figures of 15.9% and 11.4% respectively. There was no correlation between growth of ureaplasmas and the spermatozoal count. Among the morphological changes, presence of coiled tails, presence of a fuzzy coat around the tail and microcolonies were highly specific for culture positivity (98.2, 98.2 and 97.35% respectively) but of low sensitivity (55.2%, 14.1% and 8.2% respectively).

DERMATOPHYTOSIS AND DERMATOMYCOSIS IN PUNE

Dermatophytosis and dermatomycosis in patients reporting to Command Hospital (SC) were studied over a period of 3 years. A total of 126 cases were investigated. Commonest clinical diagnosis was tinea corporis (39.68%) followed by onychomycosis (20.63%). Some patients had infections of multiple sites. Direct examination under KOH and dimethyl sulfoxide (DMSO) revealed fungal elements in 43 (34.12%) cases. Fungi were isolated from 44 (34.92%) cases. Commonly isolated fungi were Candida albicans 11 (25%), Trichophyton spp 8 (18.18%), Microsporum audouinii 2(4.55%) and Epidermophyton floccosum 1(2.27%).

PLASMID MEDIATED DRUG RESISTANCE IN VIBRIO CHOLERAE 0139 BENGAL

Sixteen strains of Vibrio cholerae were isolated from cases of diarrhoea. Out of these, 12 (75%) were identified as Vibrio cholerae 0139 synonym Bengal and 4 (25%) as Vibrio cholerae El Tor by standard biochemical and serological tests. Modified CAMP reaction in sheep blood agar showed that 0139 produced moderate hemolysis, El Tor produced wider zone of hemolysis whereas Classical Vibrio cholerae produced no zone of hemolysis (CAMP negative). Break point minimum inhibitory concentration (MIC) by agar dilution method showed that all 0139 strains were resistant to ampicillin 8 mg/L, streptomycin 1 mg/L, chloramphenicol 8 mg/L, sulphamethoxazole 32 mg/L and trimethoprim 0.3-128 mg/L, 58.3% were sensitive to gentamicin 1 mg/L, and all were sensitive to norfloxacin 1 mg/L and cefotaxime 1 mg/L. Resistance to trimethoprim, sulphamethoxazole, ampicillin and gentamicin in 5 strains could be transferred to E coli K-12 by conjugation experiment at a rate of 5×10-6 to 4×10-3. Distinct plasmid bands of 35.8 mega daltons could be seen in agarose gel electrophoresis.

PREVALENCE OF ANTIBODIES TO HEPATITIS C VIRUS IN HOSPITALIZED POPULATION SUBSETS

Prevalence of antibodies to hepatitis C virus (anti-HCV antibody) was ascertained in different subsets of hospitalized patients. Anti-HCV antibody testing was done using a third generation test The anti-HCV positivity in the sera of 308 tuberculosis patients, who had been given streptomycin, was 12.3 per cent It was 7.1 percent among 84 cardiac patients undergoing invasive cardiac procedures, 15.6 per cent in 77 patients on haemodialysis and 41.2 per cent patients with surgical jaundice. It is surmised that hospitalization, particularly parenteral therapy and invasive procedures during hospitalization, puts patients at higher risk of contracting HCV infecticn.

POINTS TO PONDER FOR WRITING AN ARTICLE

is generally not given the time and effort it deserves. It is precis of the article inclusive of all the four parts mentioned Editor-in-chief. Medical Journal Armed Forces India. C/o AFMC, Pune 411040.

TO STUDY INCIDENCE OF CHLAMYDIAL GENITAL TRACT INFECTIONS USING ENZYME IMMUNO ASSAY-ANTIGEN DETECTION AND CELL CULTURE METHODS

Endocervical swabs from 315 patients were screened for chlamydial infection by using Enzyme Immuno Assay technique for antigen detection. Of these, 190 patients were of infertility and 125 patients were with history suggestive of pelvic inflammatory disease (PID). 100 age matched controls were also screened for the detection of chlamydial antigen by using EIA. The overall incidence of chlamydial infection in this study group was 15.2%. 21 (11.05%) of the infertility patients and 27 (21.6%) of the pelvic inflammatory disease cases were found to be positive for chlamydial antigen. The prevalence rate was found to be high in the age group of 31-40 years in both study groups i.e. infertility group (14.7%) and PID group (50%). All the ELISA positive cases (48) and randomly selected (10) age matched controls were screened by tissue culture using McCoy cell line. In the tissue culture, 44 of the 48 samples were found to be positive and none of the controls groups were found positive. 4 samples showed discordant results possibly due to the presence of non-viable organism or inhibitory material present at the sample site. The sensitivity and specificity of ELISA with respect to tissue culture are 100% and 71% respectively. The positive predictive value and the negative predictive value of the ELISA are 91.6% and 100% respectively. The efficiency of the test was found to be 93.1%.

ADENOCARCINOMA OF SMALL BOWEL: An Unusual Presentation

Introduction A denocarcinoma is a malignant neoplasm arising from the epithelial cell (of endoderrnal origin) of the lining of the gastrointestinal tract which microscopically shows glandular pattern. Inspite of the rapid turnover rate frequency of adenocarcinoma is very low in small bowel though lymphomas are not so uncommon. Usually the patients present late with features of intestinal colic, nausea, vomiting and at times with intestinal obstruction [7J. Sometimes the patients report with advanced disease with distant metastasis carrying poor prognosis. We present a case of adenocarcinoma of ileum which presented as acute on chronic intestinal obstruction, required emergency palliative resection and anastomosis since there were distant metastasis in lymph nodes and liver.